Sleep and dreaming in children and adolescents with epilepsy

Background. Sleep problems are frequent in children and adolescents with epilepsy. The consequences of these problems, such as sleep deprivation and fatigue, can trigger epileptic seizures. Objective. The purpose of this review was to scrutinize the effects of sleep and sleep disorders such as insomnia and parasomnias on epilepsy in childhood and adolescence. Methods. Current databases were scoured for possible combinations of sleep and epilepsy in childhood and adolescence. Results. The 24 studies included in this review showed that the most common sleep problems are disordered breathing, nightly awakenings, and excessive daytime sleepiness. A higher rate of parasomnias, shorter sleep duration, reduced sleep efficiency, and sleep-related anxieties were found more often in epileptic children. Furthermore, sleep problems are associated with the level of seizure control. However, no studies have investigated either the dreams or the chronotype of children and adolescents with epilepsy. Most of the studies used questionnaires, whereas few studies used polysomnography or actigraphy. Sometimes parents' reports were implemented. The age range of the children and adolescents was 1.5 to 18.0 years. Conclusion. The results of the current review underline the fact that sleep problems are not uncommon in children and adolescents with epilepsy. In spite of this, there is more research needed to scrutinize the connection between sleep and epilepsy, for example to work out factors influencing the sleep of epileptic children and adolescents.